JOAN EASTLACK (NPI# 1316284151) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316284151 |
| Entity Type | Individual |
| Full Name | JOAN EASTLACK |
| Credential | P.A. |
| Practice Address |
432 Panama Ave Long Beach CA 90814-1909 |
| Practice Telephone | 5629613831 |
| Mailing Telephone | 5629613831 |
| Enumeration Date | 2013-01-14 |
| Last Update Date | 2013-01-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
14906 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
432 PANAMA AVE |
| City | LONG BEACH |
| State | CA |
| Zip Code | 90814-1909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164797056 | Recovery At Sea | Community/Behavioral Health | 2345 East 4th Street, Long Beach, CA 90814 | 2012-03-12 |
| 1982869616 | James R Gaither Jr. | Rehabilitation Practitioner | 2017 E 4th Street, Long Beach, CA 90814 | 2008-07-22 |
| 1760676274 | Charles Edward Criddle | Chiropractor | 352 Newport Ave, Long Beach, CA 90814 | 2007-08-29 |
| 1891911459 | Ting-wey Yen | Dentist | 319 Redondo Ave., Long Beach, CA 90814 | 2007-04-18 |
| 1194850495 | Donna Marie Camagay Calima | Dentist | 389 Redondo Ave, Long Beach, CA 90814 | 2007-02-23 |
| 1366595332 | Roger Justin Wood | Marriage & Family Therapist | 3424 E 4th St, Long Beach, CA 90814 | 2007-01-20 |
| 1467558338 | Rudy Steven Mendoza | Dentist | 392 Redondo Ave, Long Beach, CA 90814 | 2006-09-16 |
| 1578670766 | Seany Renfrow | Psychologist | 5170 Colorado, Long Beach, CA 90814 | 2006-08-24 |
| 1245210368 | Johnny L Triplett | Anesthesiology | 4674 East Barker Way, Long Beach, CA 90814 | 2006-01-17 |
| 1992960371 | Maria Veronica Uvero Racelis | Rehabilitation Practitioner | 2017 E 4th Street, Long Beach, CA 90814 | 2008-07-24 |
| Find all providers in zip 90814 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508261256 | Trisha Luu | Physician Assistant | 3300 E. South Street, Suite 308, Long Beach, CA 90805 | 2014-10-23 |
| 1205125267 | Renae C Bright | Physician Assistant | 461 E Broadway, Long Beach #4, Long Beach, NY 11561-4437 | 2011-03-30 |
| 1881903680 | Monte Carl Burnam Physician Assistant Professional Corporation | Physician Assistant | 1145 E Amelia Dr, Long Beach, CA 90807-2403 | 2010-09-28 |
| 1912233438 | Wesley Charles Adams | Physician Assistant | 3559 E South St, Long Beach, CA 90805-4519 | 2009-10-19 |
| 1396920864 | Mohammad A Shadjari | Physician Assistant | 1635 E Ocean Blvd, Apt. F3, Long Beach, CA 90802-6001 | 2008-01-03 |
| 1710047220 | Rosemary Tilmon-kellum | Physician Assistant | 1250 Bellflower Blvd., Student Health Center, Long Beach, CA 90840 | 2006-12-12 |
| 1760542930 | Paul Scott Margraf | Physician Assistant | 2880 Atlantic Ave Ste 230, Long Beach, CA 90806-1735 | 2006-12-11 |
| 1669404380 | Bonnie Michelle Moreno Harris | Physician Assistant | 2495 Pine Ave, Long Beach, CA 90806-3029 | 2006-07-06 |
| 1952850364 | Kaitlyn Vu | Physician Assistant | 2690 Pacific Ave Ste 290, Long Beach, CA 90806-2631 | 2016-09-26 |
| 1124473178 | Jason Ryan Lomheim | Physician Assistant | 2801 Atlantic Ave, Long Beach, CA 90806-1701 | 2016-04-27 |
| Find all providers in LONG BEACH | ||||
| City | LONG BEACH |
| Zip Code | 90814 |
Please comment or provide details below to improve the information on JOAN EASTLACK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.